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Billing/Coding

CMS Updates the Medicare Conversion Factor

From the College  |  April 8, 2024

The Consolidated Appropriations Act, 2024 increased the Medicare conversion factor by 1.68% effective March 9, bringing it to $33.2875 for March 9–Dec. 31, 2024.

Congressional Action Partially Addresses Medicare Cuts

From the College  |  March 7, 2024

The newest funding package reduces the latest cut to Medicare reimbursement from 3.4% to 1.68%. Although rheumatologists are faring better under Medicare in 2024, broader reforms remain the ACR’s highest priority regarding Medicare payments to physicians.

Updated Coding Guidance for 2024 Remote Physiologic Monitoring & Therapeutic Monitoring

From the College  |  March 7, 2024

The Centers for Medicare & Medicaid Services updated recent regulations to clarify some points about remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services for key areas.

ACR Offers Lunch-and-Learn Series on Coding & Compliance for G2211

From the College  |  February 16, 2024

A free, tailored, one-hour series on coding and compliance for G2211 will help rheumatology practices bill correctly with the new add-on code to maximize reimbursements and minimize claim denials or rejections.

The ACR Advocates for G2211 Reimbursement under Medicare Advantage & Commercial Plans

From the College  |  February 3, 2024

The ACR is reaching out to Medicare Advantage and commercial payers to ensure appropriate reimbursement for the new complex care add-on code, G2211, implemented for outpatient office visits starting Jan. 1, 2024.

Updated G2211 Guidance Clarifies Use for Transient Problems

From the College  |  January 22, 2024

The complexity add-on code is appropriate to bill for an evaluation and management visit related to a transient or temporary problem when there is an established relationship for ongoing longitudinal care, even if the ongoing care is unrelated to the transient problem being treated.

Community Practice Rheumatology Is Challenging, But Rewarding, Too

Vanessa Caceres  |  January 10, 2024

Community practice rheumatology may be a less-followed path within the specialty, and it brings with it certain challenges. However, it also offers rewards, such as autonomy and deep relationships with patients. The Rheumatologist recently interviewed three community practice rheumatologists from around the U.S. to find out about their approaches to patient management, staffing and other…

2024 Remote Physiologic Monitoring and Therapeutic Monitoring Coding Guidance

From the College  |  January 9, 2024

This guidance from the ACR provides information about new remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) treatment management codes

UnitedHealthcare Working to Correct J Code Reimbursement Error

From the College  |  January 5, 2024

An error in UnitedHealthcare’s claims processing system resulted in underpayments on J code claims dated Oct. 8–Nov. 8, 2023. Practices are encouraged to review all J code payments from the final quarter of 2023.

ACR Advocates with Payers Against Insufficient Reimbursement for Biosimilars

From the College  |  November 16, 2023

The ACR is engaging with payers regarding formulary requirements that would leave practices underwater when treating patients with rheumatic diseases.

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